FAMILY PREPAREDNESS. Information your loved ones need in the event of an emergency.

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Eugenia Kathleen Webster
5 years ago
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1 FAMILY PREPAREDNESS Information your loved ones need in the event of an emergency. To protect your privacy, we recommend that you print this booklet, fill it out by hand and store it in a secure place (i.e. safety deposit box or home safe). Name: Date: Provided By: Coradi Wealth Management Richard M. Coradi Managing Director Investments Kim L. McMillan, CFP Vice President Investments cwm@investdavenport.com (757) (888) Securities and Advisory Services offered through Davenport & Company LLC Member: NYSE FINRA SIPC 101 W. Main Street, Suite 4000 Norfolk, Virginia investdavenport.com/cwm

2 PHASE FOUR Children s Information Other Dependents Miscellaneous Property & Pets Document & Property Locator The material contained herein is for informational purposes only and is not intended to be specific to any particular situation. This material has been compiled from sources believed to be reliable at the time prepared; however, Davenport does not guarantee or warrant its accuracy or completeness. Actual settlement of an estate involves additional steps, documents and responsibilities not detailed in this list. Changes may take place in the future that are not reflected in this material. Any opinions expressed here are statements of judgment on this date and are subject to future change without notice. Davenport does not render tax, legal or estate advice. No one should act upon any information herein without consulting a tax professional and/or attorney.

3 Children s Information Child 1 Child 2 Full Legal Name Address Date of Birth Place of Birth Home Phone Cell Phone Employer Supervisor/HR Phone # Health Insurance Group # Plan ID # Contact # Blood Type Allergies/Conditions Dietary Restrictions Primary Care Physician Dentist Medical Specialist 1 Medical Specialist 2 Pharmacy Name Phone Name Phone Name Dosage Prescriber Name Dosage Prescriber Do Not Resuscitate Yes Doctor Location No

4 Children s Information (2) Child 3 Child 4 Full Legal Name Address Date of Birth Place of Birth Home Phone Cell Phone Employer Supervisor/HR Phone # Health Insurance Group # Plan ID # Contact # Blood Type Allergies/Conditions Dietary Restrictions Primary Care Physician Dentist Medical Specialist 1 Medical Specialist 2 Pharmacy Name Phone Name Phone Name Dosage Prescriber Name Dosage Prescriber Do Not Resuscitate Yes Doctor Location No

5 Children s Information (3) Child 5 Child 6 Full Legal Name Address Date of Birth Place of Birth Home Phone Cell Phone Employer Supervisor/HR Phone # Health Insurance Group # Plan ID # Contact # Blood Type Allergies/Conditions Dietary Restrictions Primary Care Physician Dentist Medical Specialist 1 Medical Specialist 2 Pharmacy Name Phone Name Phone Name Dosage Prescriber Name Dosage Prescriber Do Not Resuscitate Yes Doctor Location No

6 Other Dependents Dependent 1 Dependent 2 Full Legal Name Address Date of Birth Place of Birth Home Phone Cell Phone Employer Supervisor/HR Phone # Health Insurance Group # Plan ID # Contact # Blood Type Allergies/Conditions Dietary Restrictions Primary Care Physician Dentist Medical Specialist 1 Medical Specialist 2 Pharmacy Name Phone Name Phone Name Dosage Prescriber Name Dosage Prescriber Do Not Resuscitate Yes Doctor Location No

7 Other Dependents (2) Dependent 3 Dependent 4 Full Legal Name Address Date of Birth Place of Birth Home Phone Cell Phone Employer Supervisor/HR Phone # Health Insurance Group # Plan ID # Contact # Blood Type Allergies/Conditions Dietary Restrictions Primary Care Physician Dentist Medical Specialist 1 Medical Specialist 2 Pharmacy Name Phone Name Phone Name Dosage Prescriber Name Dosage Prescriber Do Not Resuscitate Yes Doctor Location No

8 Miscellaneous Property & Pets Description Value Appraisal Docs (Y/N?) Location Art Jewelry Collectibles Other Pets Type Name Vet Name Vet # Insurance Chipped (Y/N?) (Y/N?) Animal 1 Animal 2 Animal 3 Animal 4

9 Document & Property Locator Location Notes Bills & Statements Insurance Policies Appraisal Documents Mortgage Documents Vehicle Titles Auto Loan Documents Private Mortgage Info Real Estate Deeds Rental/Lease Contracts Adoption Papers Marriage/Birth Certificates Pre/Post Nuptial Agreements Divorce Decrees Health/Medical Records Medical Directive (self) (spouse) Organ Donation Cards Funeral Arrangements Will (self) (spouse) Codicils to the Will Burial Plot Power of Attorney Inventory/Video of Assets Trust (self) (spouse) Home Safe Keys & Combinations P.O. Box Safety Deposit Box Safety Deposit Box Key Storage Units Business Agreements Tax Returns Military DD-214 Passports

10 Notes & Important Information

FAMILY PREPAREDNESS. Information your loved ones need in the event of an emergency.

FAMILY PREPAREDNESS. Information your loved ones need in the event of an emergency. FAMILY PREPAREDNESS Information your loved ones need in the event of an emergency. To protect your privacy, we recommend that you print this booklet, fill it out by hand and store it in a secure place